This invention relates generally to sensing conditions related to a human body and more particularly to sensing conditions that pertain to the care or well-being of a person who is confined to a bed or other sedentary position or who is incontinent. It also relates to providing notification in response to such sensing, which notification can be sent to the person whose conditions are being sensed or to others such as health care providers, for example. Two specific applications of the present invention that can be used separately or together relate to a medical sensor and a system and method of monitoring (1) one or more pressure sensitive areas of a human body and (2) dry/wet conditions adjacent a human body.
Although aspects of the present invention have application with regard to other human body conditions, the invention will be specifically described in the contexts of (1) pressure that contributes to the development of external skin ulcers (e.g., decubitus ulcers) and (2) wetness that occurs as a result of urinary or fecal incontinence, which can also contribute to pressure ulcer formation as well as to skin ailments such as dermatitis, etc. The invention also relates to a computer-implemented management system and method within the contexts mentioned above. The management system utilizes the number of episodes of the sensed conditions and times at which the sensed conditions occurred to formulate care protocols associated with pressure ulcer and incontinence treatment and/or prevention.
Pressure ulcers can develop in a person who is bedridden or confined to a wheelchair, for example. Intrinsic and extrinsic factors may be involved in the development of such pressure ulcers. Intrinsic factors include impaired mobility, incontinence, skin condition, nutrition, and mental status.
Exposure to pressure is one extrinsic factor. When a bony, protuberant body portion, for example, is pressed against a support such as a bed or a chair under the person's weight or part of that weight, pressure is applied to that portion. If this position is maintained for prolonged periods of time, such as due to the person's immobility, this prolonged pressure can be at least one contributing factor in causing a break in the person's skin, reduced blood flow to that tissue and the loss of surface tissue and the disintegration and necrosis of epithelial tissue (i.e., an ulcer).
Implementation of guidelines set forth by the Agency for Healthcare Research and Quality (AHRQ) has demonstrated that with diligent nursing care, many pressure ulcers are preventable. However, with staff/patient ratios typically found in nursing homes, it may be impractical to expect all aspects of the AHRQ guidelines to be followed for all but high-risk patients. The extent of this problem may grow as medical advances prolong the life expectancy of seriously ill patients and as the population over the age of 65 expands. In view of the foregoing, and as an increased number of patients are given home care, there is the need for cost effective and simple techniques and low cost equipment for pressure ulcer prevention and/or reduced healing time through improved patient monitoring methods.
Various equipment has been proposed or used in trying to prevent or treat pressure ulcers. This equipment includes overlays, replacement mattresses, and specialty beds that attempt to reduce the amount of pressure to which tissues are exposed. These vary in effectiveness, practicality of use, cost, and maintenance requirements. Although pertinent to the prevention and treatment of pressure sores, this particular equipment is distinct from the sensing and monitoring equipment and methods to which the present invention is directed.
Pressure sensing and monitoring systems have been proposed in, for example, U.S. Pat. No. 6,287,253 to Ortega et al., U.S. Pat. No. 4,554,930 to Kress and U.S. Pat. No. 5,253,656 to Rincoe et al. Another device, a Tekscan® (Tekscan, Inc. South Boston, Mass.) body pressure measurement system, monitors pressure. Other pressure analyzers have been available from Talley and Cleveland Medical Devices.
As mentioned, incontinence can also affect a person's susceptibility to decubitus ulcers, as well as to skin rashes and dermatitis, and the result of incontinence alone affects the person's immediate comfort. Thus, monitoring such as for whether an area adjacent the person is dry or wet is desirable.
Although there have been proposals and implementations addressing the general issue of human body monitoring and the specific issues of pressure and incontinence monitoring, there is still the need for novel and improved equipment and methods for sensing and monitoring one or more conditions related to the health of the human body and especially related to the development, prevention and treatment of pressure ulcers and to the detection of episodes of incontinence. There is also the need for a related computer-implemented management system and method. These preferably should facilitate the acquisition of, and notification in response to, pressure, moisture and time information that can be used in the prevention or treatment of pressure ulcers, other skin ailments, or otherwise in the care of human beings.